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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The strength-duration curve and its importance in pacing efficiency: a study of 325 pacing leads in 229 patients.
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The strength-duration curve and its importance in pacing efficiency: a study of 325 pacing leads in 229 patients.

机译：强度持续时间曲线及其在起搏效率的重要性：229例患者325次起搏铅的研究。

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摘要

Pacemaker battery life is dependent on programmable parameters, principally pulse amplitude and pulse duration. High factory default settings cause excessive current drain. The strength-duration curve relates pacing threshold to pulse duration. The most energy efficient pacing occurs at chronaxie, a value of pulse duration derived from the curve. Strength-duration curves were calculated for 325 acutely implanted pacing leads. Chronaxie and rheobase were compared for atrial and ventricular leads. Chronaxie was compared with actual programmed pulse duration. There were 101 atrial and 224 ventricular leads, all passive fixation. The curve fit was good, (mean error +/- SD) 0.024 +/- 0.06 V for atrial curves and 0.008 +/- 0.034 V for ventricular curves. Mean (+/- SD) atrial and ventricular chronaxies were 0.24 +/- 0.07 ms and 0.25 +/- 0.07 ms, respectively. A "Z" value of 1.4 indicated that chronaxies might have been from the same population. Mean (+/- SD) atrial and ventricular rheobases were 0.51 +/- 0.2 V and 0.35 +/- 0.13 V, respectively. A "Z" value of 7.1 (P < 0.001) suggested atrial and ventricular rheobases were from differing populations. All patients had factory default pulse durations of 0.45 ms or 0.5 ms, exceeding acute chronaxie by a factor of two, thus, demonstrating suboptimal pacing. We conclude that understanding the strength-duration curve is critical. Sensible programming of other pacing functions optimizes longevity. Battery drain is reduced by programming pulse duration to chronaxie with a doubling of voltage threshold at this point to achieve a safety margin. Further study of chronaxie drift with time is required.
机译：起搏器电池寿命取决于可编程参数，主要是脉冲幅度和脉冲持续时间。高出厂默认设置会导致电流过高。强度持续时间曲线涉及搏衰阈值脉冲持续时间。在Chronaxie中发生最节能的起搏，脉冲持续时间的值来自曲线。计算强度持续时间曲线对于325次急性植入的起搏引线。比较Chronaxie和Rheobase，以进行心房和心室铅。 Chronaxie与实际编程脉冲持续时间进行了比较。所有被动固定有101个心房和224个心室铅。曲线适合良好，（平均误差+/- SD）对于心房曲线和室外曲线的0.008 +/- 0.034V为0.024 +/- 0.06 V.平均（+/-SD）心房和心室计缩剂分别为0.24 +/- 0.07ms和0.25 +/- 0.07ms。 1.4的“Z”值表明计时器可能来自同一人群。平均（+/-SD）心房和心室流变酶分别为0.51 +/- 0.2V和0.35 +/- 0.13V。 7.1（p <0.001）的“Z”值表明心房和心室流变酶来自不同的群体。所有患者的出厂默认脉冲持续时间为0.45毫秒或0.5毫秒，超过急性计时的倍数，因此展示次优步行。我们得出结论，了解强度持续时间曲线至关重要。其他起搏功能的明智编程优化了寿命。通过将脉冲持续时间进行编程到Chronaxie，在此时的电压阈值加倍实现电池漏极减少，以实现安全裕度。需要使用时间的Chronaxie漂移研究。

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